| NPI | 1205843794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 630102058) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MI 6301012058) |
| 103T00000X Psychologist (Licence: MI 6301012058) | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: MI 6301012058) | |
| 103T00000X Psychologist (Licence: MI DG012058) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MI 630102508) | |
| 101YM0800X Counselor Mental Health (Licence: MI 630102508) | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: MI 630102508) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MI 6301012058) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2015-07-18 |